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Discussing Assisted Living with a Reluctant Parent

Our Los Angeles Dementia care makes our residents feel loved and at home.The desire to stay in your own home and remain independent as long as possible is a strong one. Unfortunately, as we get older we eventually reach a point where this is no longer viable or safe. How can you convince a parent that it’s time to make a move to assisted living, where they can get the support they need, and help them see the transition as a positive one? Here are several tips for having this difficult conversation. Enlist the help of a medical professional. If your parent is like most of us, he or she will have a sense of pride regarding the ability to care for him or herself. This is completely natural, and the idea that one can no longer do this is a severe blow. It is for this reason that seeking the opinion of their doctor or another healthcare provider they trust can help to add weight to your suggestions when discussing the potential move to an assisted living facility. Avoid potentially condescending sympathy. It is important to realize that, despite any health complications that your parent may be experiencing, your sympathy is not what’s needed at this moment. Of course, it is always nice to have compassion for your parent. Yet discussing the move to an assisted living facility can elicit feelings of powerlessness, and providing heaping doses of sympathy could make matters worse. Approach your parent with respect. Treat your parent as an independent person capable of making decisions and deserving of the same respect and considerations as anyone else. There are some situations where maintaining this tone could prove challenging. Diseases such as dementia can greatly impair your parent’s ability to process and understand what is happening, and may force you to take on a more guardian-like role in such cases. The underlying idea that you can still treat your parent with respect and value his or her preferences still applies more than ever. Emphasize safety. The number one priority and guiding factor in all discussions and arrangements surrounding a parent’s move to an assisted living facility should be their health and well-being. The more that you can bring this point into focus, the better the transition process will likely be. If, for example, your parent has fallen several times while unsupervised, resulting in hospital stays and broken bones, reminding them of this in a gentle and understanding manner may help them see the logic in making this transition. Above all, listen. Listening may be all you need to do to help your parent accept the idea of assisted living. It’s very possible that he or she will want to make the move, yet also feels a need to express all of his or her resentments and worries about doing so. By listening, you will help your parent feel more understood and will also help make him or her more receptive to your own feedback. There is no simple and easy way to discuss assisted living care with a parent. The process can, however, be an opportunity for you two to grow closer as you share your thoughts and feelings about the matter in an open and non-judgmental atmosphere.
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Deducting Medical Expenses to Help Pay for Assisted Living

Our LA home for the aging provides affordable care.

Photo used under Creative Commons from www.stockmonkeys.com.

Paying for assisted living is a significant financial commitment that most seniors and their families must plan for carefully. But good news! Many of the expenses of assisted living residents are tax deductible. Such deductions can help add more flexibility to the budget and free up funds that otherwise would have gone elsewhere. A major way to find tax savings is to deduct your medical expenses. Three conditions need to be satisfied in order to get the greatest possible deduction for assisted living expenses:
  • The individual must qualify as being “chronically ill.” The Health Insurance Portability and Accountability Act of 1996 defines this as needing assistance with activities of daily living (bathing, dressing, eating, etc…) or requiring continual supervision at all hours of the day.
  • Second, the ratio of the adjusted gross income of the person paying for care to the total amount of medical expenses must be greater than 7.5%.
  • Finally, the resident’s care plan must be in accordance with the recommendations of a licensed health care provider (for example, a doctor, nurse, or social worker). Most assisted living facilities will automatically provide this and residents and their families will have official documentation that meets this requirement.
If these three items apply to you, you may be able to deduct all your assisted living costs, even those related to room and board. Even if you do not qualify as chronically ill, the portion of your assisted living fees related to medical care can still be deducted, as long as total medical expenses are greater than 7.5%. Your assisted living facility should be able to provide you with information on what part of your fees are related to medical care. All documentation related to tax deductions, whether relating directly to medical expenses or otherwise, requires meticulous record keeping. This means that you will need to be diligent about itemizing every single medical expense that you believe is eligible. Obviously, fees for appointments and prescriptions are part of this, but you can also deduct less-obvious health-related costs such as eye glasses, dentures, canes and walkers, transportation to appointments, etc… If you pay premiums for long-term care insurance, these are deductible as well. However, you cannot deduct the portion of your assisted living fees paid for by your long-term care insurance. For more information about the tax implications of being an assisted living resident, consult with your accountant to learn how the options apply to your specific situation. Your accountant can also help you identify additional tax credits that you may qualify for, as well as guide you with similar deductions for your state tax return.    
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The Benefits of Assisted Living Over In-Home Care

Deciding whether to choose assisted living or home care is tough, and many emotions come up which influence the decision-making process. When you realize that you or a loved one needs some outside help, which option will work better? The answer of course is different for each individual and family, but there are certain considerations that tend to come up again and again. Two of the key features of assisted living facilities are that they’re designed so that seniors can be as independent as possible while remaining safe, and that they provide services in a cost-efficient manner (since they are shared by several or more people). On the other hand, home care has the undeniable advantage of the senior being able to remain in their home and/or with loved ones. However, the coziness of home care can also be one of its disadvantages. Having someone in the household with such extensive needs can be a burden for others in the family. We all want to feel like we’re doing as much as we can for aging loved ones, but caregiver burn-out is a real issue. Remember that before you can help others, you must help yourself: if you’re stressed or feeling negative, the senior in your life isn’t getting the best help. Allowing assisted living to take on the chores of daily care may allow you to spend the time connecting with your loved one and enjoying each other’s company. Another major issue that you should consider is the cost of the two options. Assisted living can be a very affordable solution that gives you a lot of value for your money. Just about all of life’s needs are taken care of in one fee: housing, food, utilities, housekeeping, and social activities, plus the care and assistance that helps the senior get through daily life. Many feel that a lot of worries have been taken off their shoulders when they move to assisted living. With home care, though, you’re paying on an hourly basis. The average cost of home care in California is $20 per hour, so that adds up quickly even before you throw in other needs like food and housing. Since you are managing home care yourself, you’ll need to have a plan when a hired caregiver cannot come in due to illness or any other reason. This can be addressed by using an agency, but the agency will charge higher-than-average fees for the convenience of knowing someone will always be there. Again, be sure to take into account your individual needs. There are some situations in which home care may be more appropriate. Before committing to one choice or the other, do thorough research on the actual cost and make sure you truly understand your options. Then this challenging decision may become a little more clear.
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Visits from Grandchildren in Assisted Living

Few things can brighten a senior’s day like a visit from their grandchildren and great-grandchildren. These visits can help add purpose to a senior’s life and help them maintain a connection to a world outside the facility and to the family. It also gives the grandchildren a valuable chance to get to know the grandparent. Being able to see how much they mean to older family members is an important experience for the child. But it can be challenging to think of ways to make this time meaningful and enjoyable. The first step is to prepare the child for visiting the facility. Describe what it’s like and perhaps even show pictures. Explain the purpose of assisted living and why the family decided grandma or grandpa should be there. Explain what behavior will be expected. Be sure to emphasize how happy the senior will be to see the child, but also make sure they know that their grandparent may not be feeling well that day. What to do during the visit can be a challenge. If everyone just sits around in grandma’s room, it will be boring for the children and unsatisfying for the senior. Instead, have a plan. Here are some ideas:
  • Bring children at a time when the residents are socializing. That way, the senior can introduce the child to friends and have a chance to show off their wonderful grandchildren.
  • Wear Halloween costumes so that the grandparent can see in person how cute they look and what creative ideas everyone came up with. There may be other holidays where the children are dressing up, such as Purim or Christmas, and they can show their grandparent their special outfits for these times too.
  • Have children bring a recent school project that they can show to their grandparent. Seniors are likely to be very interested in seeing what kids are learning in school these days. If the project is about something the senior doesn’t know about, that gives the child a chance to be the teacher.
  • Play games. The child can bring a favorite game to share with the grandparent, and it’s likely that the grandparent has a favorite game of their own that they can teach the child.
  • Decorate the senior’s room for an upcoming holiday. Decorations often bring out lots of excitement in children, and seniors will feel loved and have a reminder of the visit after the children have left.
  • Share riddles and jokes and silly songs. Children might be very interested to hear some of the songs the grandparent remembers from when they were the child’s age.
  • Bring photographs or video of a recent event in the child’s life, such as a chorus concert, ball game, or scouting trip. Have the child tell the grandparent stories about what happened.
  • If you’re willing to take on a bigger project, talk to the assisted living facility and the child’s school about arranging a class visit. The children could sing for the seniors or perform a skit. Another idea is to have children interview the seniors about their lives, and use the information to write short biographies that can be compiled into a collection for both seniors and the children to keep.
Seniors will be especially delighted to receive gifts, and children will feel good preparing something for them. Have children draw a picture or make a card for their grandparent. You also might consider baking sweets or making some other kind of favorite food with the child that they can then give to the senior. These are just a few ideas as to how you can create wonderful memories from children’s visits. Just because a grandparent is now in assisted living, their relationship with the family doesn’t have to suffer. In the process, children will learn valuable lessons about giving and bringing cheer to others, and they will get to enjoy precious time with their grandparent that they’ll be able to remember one day when they’re gone.
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Four Ways Seniors Can Keep Their Minds Sharp

Seniors entering assisted living may need help with daily tasks due to the physical limitations of old age, but often their minds are still relatively healthy. These seniors can benefit from taking simple actions that will help them continue to maintain their mental abilities. 1. Take on puzzles and games. Exercise the mind with logic challenges to keep it active. Card games are a great example: those seniors who enjoy bridge, even without realizing it, are doing more for themselves than simply having a good time enjoying competition with friends. Board games like monopoly are good choices too, and don’t forget the ever-popular Bingo (play with multiple cards to get the most brain-stimulating challenge)! Sodoku and crossword puzzles work well. The best benefit from games comes when there’s a social aspect to them: interacting with others provides additional stimulation and challenge. 2. Be social. If you’re not someone who enjoys games, even social interaction itself can benefit the mind. Talk to other residents and get to know them. Take an interest in the staff members you come into contact with and ask them about their lives outside of work–with their demanding and sometimes emotionally draining jobs, many caregivers will appreciate the chance to make a personal connection and be recognized. Check out activites being offered by the community. Social interaction has had documented positive effects not just on the mind, but on overall health as well. Seniors in assisted living, who have a community readily available, are well-situated to take advantage of these benefits. 3. Eat properly. Good nutrition and regular meals are good for both the body and the brain. Your assisted living facility can be a big help with this, providing healthy food on schedule without you having to worry about it. Eat a variety of things and for mental benefits specifically focus on colorful fruit, leafy green vegetables, and foods with omega-3 fatty acids like nuts and fish. Drink water often: seniors are more likely to become dehydrated than younger adults. 4. Move. We think of exercise as benefiting the body, but our minds thrive on it too. Don’t shy away from the chance to be active. Coordinated movements, especially dancing, can be great for keeping yourself sharp. Line dancing, for example, forces you to use your memory to learn and remember the steps. Another option is to go for a walk, even if it’s just around the hallways of the facility. Seniors have been shown to benefit from light strength training and low-impact aerobic exercises designed for them. Physical activity increases your oxygen use and blood flow to your brain. Whatever exercise you choose, to get the benefits it’s important that you be consistent.
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Considering Life Insurance Settlements to Pay for Assisted Living

You may have recently heard about the option of life settlements, where you sell your life insurance policy to a third party, and be considering this option in order to fund assisted living. The buyer of the policy takes responsibility for the premiums, and then receives the benefit when you pass away. These offers are certainly tempting, but make sure you’re considering all the possibilities open to you first. For example, you may be able to take out a loan on the cash value of the policy. You may also be able to reduce the death benefit in exchange for lowered premiums, which will allow you to hold on to the policy and some of its value. Finally, if you are terminally or chronically ill, you may be able to receive an accelerated death benefit while you’re still alive. Don’t make the decision to give up your life insurance lightly: if your policy has value to investors, it also has value to your heirs. Remember why you bought the policy in the first place. On the other hand, if it’s likely you will lapse on your policy anyway, a life settlement can make a lot of sense. If you have decided that a life settlement is the best choice for your situation, make sure you do your research. Different life settlement providers may make you different offers, so be sure to shop around. You may want to consider using a life settlement broker, who will act in your best interest. Also know that you do not need to sell your whole policy: you may be able to arrange to keep a portion of the benefits. How much you can get for our policy will depend on your life expectancy, how much needs to be paid in premiums to keep the policy in force, and the policy’s cash value. Think through the various implications of receiving such a large sum of money. Some of the settlement may be taxable, and any creditors you have may be able to claim the money. Also consider whether your social security or any other public benefits you receive will be affected. Beware of schemes where you buy life insurance with an agreement to sell it later. This is called Stranger-Originated Life Insurance (or STOLI) and it’s illegal in most states. Insurers may refuse to pay benefits on these arrangements. To learn more and to find out how life settlements apply to your specific situation, consult with your insurance agent, a financial advisor, or lawyer.
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Seniors and Pet Separation

Many of us have pets we love dearly in our lives. Seniors often find pets to be good companions when they live on their own. Indeed, studies have shown that having a pet is great for one’s health. However, pets often cannot move with a senior to assisted living, and even if they can there’s many reasons why it might not be a practical decision. What will happen to the pet is often the biggest concern about the move. It’s common for people to feel wracked by guilt over abandoning a beloved friend they have taken on the responsibility to care for. However, this guilt is misplaced if the senior is having trouble caring for the pet and it would be better off with other owners. Seniors who are ready for assisted living may have trouble with taking the dog for a walk, feeding or cleaning their pet, or getting to the vet or to the store for supplies. Indeed, families concerned about mom or dad can get a clue to how well they are able to be on their own by observing how the pet is doing. One possible solution is for the senior’s family members or a friend to adopt the pet. They can bring the animal to see their loved one regularly. Even if the pet cannot come into the facility, the senior can be brought outside to say hello. This is the ideal solution for reducing the trauma of pet separation. If this is not possible and the senior doesn’t know anyone, even living far away, who can take the pet, it will probably have to be surrendered to a shelter. Giving the animal away to strangers is not always a great idea, as they can end up with an abusive or irresponsible owner. Seek out a well-funded “no-kill” shelter to receive the animal. It’s a good sign if you have to make an appointment to surrender the pet: this shows that the shelter is working to manage their intake of new animals. There’s a good chance the pet will find a new family. Find out in advance if your pet has any issues that will make it “unadoptable” in the shelter’s eyes. Especially if the pet is old, make sure to provide the shelter with veterinary records. If a loved one entering assisted living is bereft over the loss of a pet, try to compensate with plenty of human companionship. Make sure that the senior’s family and friends visit often. Feeling involved in a community can help with the loss.
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Holding Family Meetings About Senior Care

Meetings can be very useful when a family is faced with a tough decision, like whether to move a parent to assisted living. They provide a chance for relatives to come together, pool their knowledge, and discuss various options and strategies. It can be tough even to make the decision to hold such a meeting. The most important family members may not all live close together, so location is a challenge. People’s schedules are packed and some may be reluctant to add one more thing to the calendar. Sometimes it’s assumed that other relatives don’t want to get together. However, it never hurts to ask. Due to the serious nature of the decision, people may be more inclined to be cooperative. And if their lives are heavily affected by caring for mom or dad, they will be interested in solutions that will improve the situation. It is important to include the affected senior, even if it means overcoming challenges presented by physical or mental disability or resistance to facing the need for care. There are several reasons why you may feel this is inappropriate, but making sure your loved one is included in the process is vital to making any solution work. They deserve the respect of knowing that they have say in decisions affecting their life, and you can’t find a solution for them unless you have their own opinion on what their needs are. You may be surprised to learn how they see the issue. This does not mean that the solution mom or dad would choose on their own is necessarily the best one and that they have final say, but you do need to take into account their concerns. Consider including any paid caregivers or others who provide household services. The cleaning lady who comes in on Fridays may have noticed something you haven’t. Also consider bringing in the senior’s friends and neighbors. A social worker or for families where religion is important, a spiritual advisor, may also be helpful. Try to plan the meeting at a time when it’s easier for far-flung family to travel, perhaps during the holidays. When planning the agenda, make sure everyone will get a chance to speak so that they can make their case for what is important to them, and be sure to devote significant time to what the senior has to say themselves. Have everyone in the group review the agenda in advance. Also choose people to take on different tasks: someone who can be a neutral facilitator, someone to take notes, someone to keep time. Plan to hold the meeting in a place that will comfortable and have food and beverages available. Try to choose somewhere that allows a layout where everyone can make eye contact with one another. Tension exists in any family, even those where the members are close and get along well. It’s a normal part of life. Bringing everyone together at once will cause these problems to rise to the surface. Keep conflict to a minimum by focusing everyone on finding solutions for the future, not on rehashing past grief. Remind everyone that there will be no perfect solution and there will have to be compromise in some form. You won’t be able to fix everything then and there. The point is to gather perspectives and come up with practical answers. When you’ve finished the meeting, send the notes to people who were interested but unable to attend, and follow up on whatever course of action was agreed upon. Even if you decide that assisted living is not the right choice now, in time your parent is very likely to need help. Make plans to have them visit facilities you are considering and prepare for an eventual move. It never hurts to have alternate solutions available for when they might be needed. The one thing you can always count on is change.
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The Challenge of Eating Well for Seniors

One of the hardest things for seniors living on their own is having meals that are both nutritious and enjoyable. Cooking for one person is tough enough when you’re young and energetic, but when everyday tasks are more difficult and you move more slowly, it’s that much more difficult. Some seniors can’t get out to the grocery store to even get food to begin with. Especially when it comes to men and others who may not have done much cooking earlier in their lives, making your own meals can seem like an impossible task. In these situations, seniors tend to go for what’s quick and easy, not what would be the most ideal choice from a health standpoint. In addition, seniors living by themselves eat alone much of the time. Having dinner with only the TV for company can be pretty lonely. Even if the senior lives with family, how often in busy homes with kids does everyone come together to share a meal? Despite the living situation the end result may be the same: a microwave dinner in front of the evening news while children stay late to deal with work responsibilities and grandchildren attend basketball practice or reherse for the school play. This scenario may make the senior feel even more cast aside. To be fair, some seniors are still excellent cooks and can fend for themselves. But the chances are good that sooner or later, food will become an issue. When it does, it can contribute to making a senior’s delicate health even worse. Poor nuturition makes people more likely to get sick, can exacerbate conditions like Alzheimer’s and dementia, and can lead to depression. Those who are concerned about their older loved ones should not wait for the senior to ask for help, as sometimes they will fear the loss of their independence and hide problems. Watch for clues like excessive weight loss or a refrigerator with barren shelves or expired food. Consider whether getting to the grocery store is a challenge: does the senior have trouble getting outside his or her home? You also may want to ask if he or she is having problems with swallowing or chewing or if they’re experiencing a loss of appetite. This is one area in which assisted living can make a big difference in a senior’s life. Assisted living residents do not have to worry about cooking for themselves. They get to have regular mealtimes within a community and experience the comfort of gathering together with people they know. A good assisted living facility will make sure the senior gets the proper diet for his or her specific health issues. We all feel happier when eating well and enjoying good company. Attention to this area can be a huge boost in a senior’s quality of life.
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Understanding Assisted Living Costs

When they first see the cost of assisted living, many people are taken aback. Their first reaction is that it’s “too expensive,” especially compared to having the senior just live at home. While this initial response is understandable, it’s not quite accurate. You need to take into account all the benefits that assisted living provides, and compare it to total monthly expenses incurred outside of assisted living, before you make a judgment. To get an accurate sense of the relative cost, you need to start with an accurate budget. Look at your financial records closely and see what you really spent over the last few months. It’s easy to underestimate what you spent on food, for example, and forget about small impulse purchases. Once you do that, you are more prepared to evaluate the price tag of a given assisted living facility. The monthly fee will cover all basic needs: food, housing, and utilities. In addition, that fee also provides housekeeping, health monitoring, repairs and maintenance of your living space and yard, security, entertainment, and trash removal. You should especially consider the value of the social activities that assisted living facilities provide. Many seniors are isolated living on their own, or skimping on entertainment in order to save money. But in assisted living these things are part of the whole package. Many seniors value these living arrangements precisely because of the chance to have a good time with people their own age. Activities and socialization also help seniors maintain their physical and mental well-being. Senior couples may receive additional value from assisted living that aren’t immediately revealed by the numbers. Many wives see their workloads increase when their husbands retire, as they now have to care for someone full-time. Assisted living can finally allow both partners to take a break because someone else is worrying about the chores. Husband and wife can simply enjoy each other’s company instead. Don’t let the price of assisted living deter you from taking a closer look. People forget to take into account all the things that assisted living provides which inflate the cost of the senior living on their own. And it’s impossible to put a price on enjoying those last years without worry about the lawn or the leaky roof, and also knowing that you or your loved one has someone immediately available to help them, at any time of the day or night. You’ll likely find, as many have, that assisted living is actually a better value than your other options.
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